JMIR Publications

ABSTRACT

Background:

Mental and neurological disorders cause a large proportion of morbidity burden and require adequate health care structures. However, deficits in the German health care system like long waiting times for access to specialized care and a lack of coordination between health care providers lead to suboptimal quality of care and elevated health care costs.

Objective:

To overcome these deficits we implement and evaluate a unique stepped and coordinated model of care (the NPPV program) for patients with mental and neurological diseases.

Methods:

Patients included in the program receive an appropriate treatment according to medical needs in a multi-professional network of ambulatory health care providers. The therapy is coordinated by a managing physician and complemented by additional therapy modules, such as group therapy, Internet-based Cognitive Behavioral Therapy and a case management. Statutory health insurance (SHI) routine data and data from a longitudinal patient survey will be used to compare the program with regular care and evaluate SHI expenditures and patient related-outcomes. A health care provider survey will evaluate the quality of structure and processes and provider satisfaction. Finally, an analysis of ambulatory claims data and drug prescription data will be used to evaluate if health care providers follow a needs-led approach in therapy.

Results:

Patient enrollment of NPPV ended in September 2021. The results of this study are expected to be available in 2022 and will be disseminated through scientific publications, academic conferences and a publicly available report to the German Federal Joint Committee GBA.

Conclusions:

The NPPV program is the first intervention to implement a stepped model of care for both mental and neurological diseases in Germany. The analysis of several data sources and a large sample size (more than 14,000 patients) enable a comprehensive evaluation of the NPPV program. Clinical Trial: Identifier DRKS00022754 in the German Clinical Trials Register. The study has received approval from the ethics committee of the chamber of physicians in North Rhine.